Sociocultural factors influencing exclusive breastfeeding: a review from public health perspective.
Keywords:
exclusive breastfeeding; sociocultural factors; public health; social determinants of health; social support
Abstract
Objective: To identify and synthesize sociocultural factors influencing the practice of exclusive breastfeeding (EBF) during the first six months of life. Materials and methods: A systematic review was conducted following PRISMA guidelines, using PubMed as the sole source between May and June 2025. Studies published from 2015 to 2025 with qualitative, quantitative, or mixed-methods designs were included. Results: Twenty studies were included, highlighting five main categories of sociocultural factors: knowledge and beliefs about breastfeeding, family and community support, myths and religion, work conditions, and gender roles. The findings revealed that EBF is shaped by the sociocultural environment, where factors such as maternal education, social support, labor rights, and cultural norms significantly impact breastfeeding practices. Conclusion: EBF should not be viewed solely as an individual choice, but rather as a socially conditioned behavior. Therefore, promotion strategies must be multisectoral, involving public policies, gender equity, education, and institutional support to create enabling environments for breastfeeding.
Downloads
Download data is not yet available.
References
1. Mangrio E, Persson K, Bramhagen AC. Sociodemographic, physical, mental and social factors in the cessation of breastfeeding before 6 months: a systematic review. Scand J Caring Sci. junio de 2018;32(2):451-65.
2. Amzat J, Aminu K, Matankari B, Ismail A, Almu B, Kanmodi KK. Sociocultural context of exclusive breastfeeding in Africa: A narrative review. Health Sci Rep. 12 de mayo de 2024;7(5):e2115.
3. Miranda AR, Barral PE, Scotta AV, Cortez MV, Soria EA. An overview of reviews of breastfeeding barriers and facilitators: Analyzing global research trends and hotspots. Glob Epidemiol. 1 de junio de 2025;9:100192.
4. Nasrabadi M, Vahedian-Shahroodi M, Esmaily H, Tehrani H, Gholian-Aval M. Factors affecting Exclusive breastfeeding in the first six months of birth: An Exploratory- Descriptive Study. J Midwifery Reprod Health. 1 de julio de 2019;7(3):1759-74.
5. Nsiah-Asamoah C, Doku DT, Agblorti S. Mothers’ and Grandmothers’ misconceptions and socio-cultural factors as barriers to exclusive breastfeeding: A qualitative study involving Health Workers in two rural districts of Ghana. Enuameh YAK, editor. PLOS ONE. 17 de septiembre de 2020;15(9):e0239278.
6. Mohammed S, Yakubu I, Fuseini AG, Abdulai AM, Yakubu YH. Systematic review and meta-analysis of the prevalence and determinants of exclusive breastfeeding in the first six months of life in Ghana. BMC Public Health. 19 de mayo de 2023;23(1):920.
7. Moret-Tatay A, Pérez-Bermejo M, Asins-Cubells A, Moret-Tatay C, Murillo-Llorente MT. A Systematic Review of Multifactorial Barriers Related to Breastfeeding. Healthcare. enero de 2025;13(11):1225.
8. Hirani SAA, Richter S, Salami B, Vallianatos H. Sociocultural Factors Affecting Breastfeeding Practices of Mothers During Natural Disasters: A Critical Ethnography in Rural Pakistan. Glob Qual Nurs Res. 1 de enero de 2023;10:23333936221148808.
9. Frenoy P, Vandentorren S, Arnaud A, Vuillermoz C, Rico Berrocal R, Martin-Fernandez J, et al. Demographic, socioeconomic, and sociocultural factors associated with any breastfeeding in homeless mothers. Matern Child Nutr. 2021;17(3):e13167.
10. Apara EF, Olawade DB, Olatunji GD, Kokori E, Aderinto N, Clement David-Olawade A. Factors influencing nursing mothers’ exclusive breastfeeding practices and their effects on infants aged zero to six months in Nigeria: A review of current evidence. Women Child Nurs. 1 de septiembre de 2024;2(3):49-55.
11. Morales PPR, Torres MGZ, Sánchez-Delgado M. Factores socioculturales que influyen en la práctica de la lactancia y la alimentación de la madre en una comunidad semiurbana de México. Poblac Salud En Mesoamérica [Internet]. 30 de junio de 2023 [citado 4 de junio de 2025]; Disponible en: https://revistas.ucr.ac.cr/index.php/psm/article/view/52851
12. Awawdi K, Yahya O, Sabbah M, Bisharat S, Tarabeih M. Factors Influencing Exclusive Breastfeeding Amongst Arab Mothers in Israel: Social, Cultural, and Occupational Aspects. Healthcare. enero de 2025;13(8):852.
13. Vázquez-Osorio IM, Vega-Sánchez R, Maas-Mendoza E, Heller Rouassant S, Flores- Quijano ME. Exclusive Breastfeeding and Factors Influencing Its Abandonment During the 1st Month Postpartum Among Women From Semi-rural Communities in Southeast Mexico. Front Pediatr [Internet]. 18 de febrero de 2022 [citado 4 de junio de 2025];10. Disponible en: https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2022.826295/full
14. Amekpor F, Osei-Mensah C, Adjieteh NA, Dok-Yen EN, Salamu MB. Exploring Psycho- Social Factors Influencing Exclusive Breastfeeding: Lived Experiences of First Time Mothers at Salaga Municipal Hospital, Savannah Region in Ghana. Int J Public Health. 30 de enero de 2025;70:1607542.
15. Fajar NA, Ananingsih ES, Sulaningsi K, Firdaust M, Yudhastuti R, Diana R, et al. Social Determinant of Health on Exclusive Breastfeeding Practice in South Sumatra, Indonesia. 2024;
16. Wanjohi M, Griffiths P, Wekesah F, Muriuki P, Muhia N, Musoke RN, et al. Sociocultural factors influencing breastfeeding practices in two slums in Nairobi, Kenya. Int Breastfeed
J. 11 de enero de 2017;12(1):5.
17. Sosseh SAL, Barrow A, Lu ZJ. Cultural beliefs, attitudes and perceptions of lactating mothers on exclusive breastfeeding in The Gambia: an ethnographic study. BMC Womens Health. 13 de enero de 2023;23(1):18.
18. Shi H, Yang Y, Yin X, Li J, Fang J, Wang X. Determinants of exclusive breastfeeding for the first six months in China: a cross-sectional study. Int Breastfeed J. 17 de mayo de 2021;16:40.
19. Alshammari MB, Haridi HK. Prevalence and Determinants of Exclusive Breastfeeding Practice among Mothers of Children Aged 6–24 Months in Hail, Saudi Arabia. Scientifica. 27 de marzo de 2021;2021:2761213.
20. Thompson GH, Sefa E, Deshpande AS, Mensah R, Lenzi-Weisbecker R, Wilder R, et al. Factors associated with exclusive breastfeeding for the first six months among caregivers of children under five years in northern Ghana: A cross-sectional study. PLOS Glob Public Health. 14 de noviembre de 2024;4(11):e0003887.
21. Arnedillo-Sánchez S, Suffo-Abouza JA, Carmona-Rodríguez MÁ, Morilla-Romero-de-la- Osa R, Arnedillo-Sánchez I. Importance Assigned to Breastfeeding by Spanish Pregnant Women and Associated Factors: A Survey-Based Multivariate Linear Correlation Study. Nutrients. 2 de julio de 2024;16(13):2116.
22. Islam MdR, Tamanna T, Mohsin NA, Tanha AF, Sheba NH, Hannan J. Prevalence and barriers to early initiation of breastfeeding among urban poor full-time readymade garments working mothers: a mixed-methods study in Bangladesh. Int Breastfeed J. 18 de junio de 2024;19:42.
23. Hassen HM. Trends and disparities in ever-breastfeeding practice and early breastfeeding initiation in Ethiopia: a 20-year trend analysis from EDHS datasets. BMC Public Health. 19 de septiembre de 2024;24:2558.
24. Martín-Ramos S, Domínguez-Aurrecoechea B, García Vera C, Lorente García Mauriño AM, Sánchez Almeida E, Solís-Sánchez G. [Breastfeeding in Spain and the factors related to its establishment and maintenance: LAyDI Study (PAPenRed)]. Aten Primaria. enero de 2024;56(1):102772.
25. Tran V, Reese Masterson A, Frieson T, Douglass F, Pérez‐Escamilla R, O’Connor Duffany
K. Barriers and facilitators to exclusive breastfeeding among Black mothers: A qualitative study utilizing a modified Barrier Analysis approach. Matern Child Nutr. 13 de septiembre de 2022;19(1):e13428.
26. Gizaw AT, Sopory P, Sudhakar M. Barriers and coping responses towards infant and young child feeding practices in rural Ethiopia: a descriptive qualitative study. BMJ Open. 11 de octubre de 2023;13(10):e077008.
27. Meher C, Zaluchu F. Cultural Influences of Early Food Introduction on Exclusive Breastfeeding Rates in the Nias Islands, Indonesia. J Multidiscip Healthc. 29 de noviembre de 2024;17:5653-63.
28. Abou Jaoude M, Moukarzel S, Kremers SPJ, Gubbels JS. Factors Related to Breastfeeding Support in Lebanese Daycare Centers: A Qualitative Study among Daycare Directors and Employees. Int J Environ Res Public Health. 8 de junio de 2021;18(12):6205.
29. Joseph FI, Earland J. A qualitative exploration of the sociocultural determinants of exclusive breastfeeding practices among rural mothers, North West Nigeria. Int Breastfeed
J. 20 de agosto de 2019;14:38.
30. Rech RS, Chávez BA, Fernandez PB, Fridman CG, Faustino-Silva DD, Hilgert JB, et al. Factors associated with the initiation of breastfeeding in a maternity hospital in Lima, Peru. CoDAS. 28 de junio de 2021;33:e20200173.
31. Gallegos D, Parkinson J, Duane S, Domegan C, Jansen E, Russell-Bennett R. Understanding breastfeeding behaviours: a cross-sectional analysis of associated factors in Ireland, the United Kingdom and Australia. Int Breastfeed J. 2 de diciembre de 2020;15:103.
32. Sharma P, Bansal N, Kaul A. Exclusive breastfeeding practices and factors affecting them in urban areas of Uttar Pradesh. J Fam Med Prim Care. enero de 2025;14(1):38-44.
33. Nuño Martínez N, Wallenborn J, Mäusezahl D, Hartinger SM, Muela Ribera J. Socio- cultural factors for breastfeeding cessation and their relationship with child diarrhoea in the rural high-altitude Peruvian Andes – a qualitative study. Int J Equity Health. 16 de julio de 2021;20:165.
34. Rodríguez-Gallego I, Corrales-Gutierrez I, Gomez-Baya D, Leon-Larios F. Effectiveness of a Postpartum Breastfeeding Support Group Intervention in Promoting Exclusive Breastfeeding and Perceived Self-Efficacy: A Multicentre Randomized Clinical Trial. Nutrients. 28 de marzo de 2024;16(7):988.
35. Diji AKA, Bam V, Asante E, Lomotey AY, Yeboah S, Owusu HA. Challenges and predictors of exclusive breastfeeding among mothers attending the child welfare clinic at a regional hospital in Ghana: a descriptive cross-sectional study. Int Breastfeed J. 9 de marzo de 2017;12:13.
36. Nurokhmah S, Rahmawaty S, Puspitasari DI. Determinants of Optimal Breastfeeding Practices in Indonesia: Findings From the 2017 Indonesia Demographic Health Survey. J Prev Med Pub Health. marzo de 2022;55(2):182-92.
37. Branco J, Manuel AR, Completo S, Marques J, Rodrigues Antão R, Pinto Gago C, et al. Prevalence and Predictive Factors of Exclusive Breastfeeding in the First Six Months of Life. Acta Med Port. 1 de junio de 2023;36(6):416-23.
2. Amzat J, Aminu K, Matankari B, Ismail A, Almu B, Kanmodi KK. Sociocultural context of exclusive breastfeeding in Africa: A narrative review. Health Sci Rep. 12 de mayo de 2024;7(5):e2115.
3. Miranda AR, Barral PE, Scotta AV, Cortez MV, Soria EA. An overview of reviews of breastfeeding barriers and facilitators: Analyzing global research trends and hotspots. Glob Epidemiol. 1 de junio de 2025;9:100192.
4. Nasrabadi M, Vahedian-Shahroodi M, Esmaily H, Tehrani H, Gholian-Aval M. Factors affecting Exclusive breastfeeding in the first six months of birth: An Exploratory- Descriptive Study. J Midwifery Reprod Health. 1 de julio de 2019;7(3):1759-74.
5. Nsiah-Asamoah C, Doku DT, Agblorti S. Mothers’ and Grandmothers’ misconceptions and socio-cultural factors as barriers to exclusive breastfeeding: A qualitative study involving Health Workers in two rural districts of Ghana. Enuameh YAK, editor. PLOS ONE. 17 de septiembre de 2020;15(9):e0239278.
6. Mohammed S, Yakubu I, Fuseini AG, Abdulai AM, Yakubu YH. Systematic review and meta-analysis of the prevalence and determinants of exclusive breastfeeding in the first six months of life in Ghana. BMC Public Health. 19 de mayo de 2023;23(1):920.
7. Moret-Tatay A, Pérez-Bermejo M, Asins-Cubells A, Moret-Tatay C, Murillo-Llorente MT. A Systematic Review of Multifactorial Barriers Related to Breastfeeding. Healthcare. enero de 2025;13(11):1225.
8. Hirani SAA, Richter S, Salami B, Vallianatos H. Sociocultural Factors Affecting Breastfeeding Practices of Mothers During Natural Disasters: A Critical Ethnography in Rural Pakistan. Glob Qual Nurs Res. 1 de enero de 2023;10:23333936221148808.
9. Frenoy P, Vandentorren S, Arnaud A, Vuillermoz C, Rico Berrocal R, Martin-Fernandez J, et al. Demographic, socioeconomic, and sociocultural factors associated with any breastfeeding in homeless mothers. Matern Child Nutr. 2021;17(3):e13167.
10. Apara EF, Olawade DB, Olatunji GD, Kokori E, Aderinto N, Clement David-Olawade A. Factors influencing nursing mothers’ exclusive breastfeeding practices and their effects on infants aged zero to six months in Nigeria: A review of current evidence. Women Child Nurs. 1 de septiembre de 2024;2(3):49-55.
11. Morales PPR, Torres MGZ, Sánchez-Delgado M. Factores socioculturales que influyen en la práctica de la lactancia y la alimentación de la madre en una comunidad semiurbana de México. Poblac Salud En Mesoamérica [Internet]. 30 de junio de 2023 [citado 4 de junio de 2025]; Disponible en: https://revistas.ucr.ac.cr/index.php/psm/article/view/52851
12. Awawdi K, Yahya O, Sabbah M, Bisharat S, Tarabeih M. Factors Influencing Exclusive Breastfeeding Amongst Arab Mothers in Israel: Social, Cultural, and Occupational Aspects. Healthcare. enero de 2025;13(8):852.
13. Vázquez-Osorio IM, Vega-Sánchez R, Maas-Mendoza E, Heller Rouassant S, Flores- Quijano ME. Exclusive Breastfeeding and Factors Influencing Its Abandonment During the 1st Month Postpartum Among Women From Semi-rural Communities in Southeast Mexico. Front Pediatr [Internet]. 18 de febrero de 2022 [citado 4 de junio de 2025];10. Disponible en: https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2022.826295/full
14. Amekpor F, Osei-Mensah C, Adjieteh NA, Dok-Yen EN, Salamu MB. Exploring Psycho- Social Factors Influencing Exclusive Breastfeeding: Lived Experiences of First Time Mothers at Salaga Municipal Hospital, Savannah Region in Ghana. Int J Public Health. 30 de enero de 2025;70:1607542.
15. Fajar NA, Ananingsih ES, Sulaningsi K, Firdaust M, Yudhastuti R, Diana R, et al. Social Determinant of Health on Exclusive Breastfeeding Practice in South Sumatra, Indonesia. 2024;
16. Wanjohi M, Griffiths P, Wekesah F, Muriuki P, Muhia N, Musoke RN, et al. Sociocultural factors influencing breastfeeding practices in two slums in Nairobi, Kenya. Int Breastfeed
J. 11 de enero de 2017;12(1):5.
17. Sosseh SAL, Barrow A, Lu ZJ. Cultural beliefs, attitudes and perceptions of lactating mothers on exclusive breastfeeding in The Gambia: an ethnographic study. BMC Womens Health. 13 de enero de 2023;23(1):18.
18. Shi H, Yang Y, Yin X, Li J, Fang J, Wang X. Determinants of exclusive breastfeeding for the first six months in China: a cross-sectional study. Int Breastfeed J. 17 de mayo de 2021;16:40.
19. Alshammari MB, Haridi HK. Prevalence and Determinants of Exclusive Breastfeeding Practice among Mothers of Children Aged 6–24 Months in Hail, Saudi Arabia. Scientifica. 27 de marzo de 2021;2021:2761213.
20. Thompson GH, Sefa E, Deshpande AS, Mensah R, Lenzi-Weisbecker R, Wilder R, et al. Factors associated with exclusive breastfeeding for the first six months among caregivers of children under five years in northern Ghana: A cross-sectional study. PLOS Glob Public Health. 14 de noviembre de 2024;4(11):e0003887.
21. Arnedillo-Sánchez S, Suffo-Abouza JA, Carmona-Rodríguez MÁ, Morilla-Romero-de-la- Osa R, Arnedillo-Sánchez I. Importance Assigned to Breastfeeding by Spanish Pregnant Women and Associated Factors: A Survey-Based Multivariate Linear Correlation Study. Nutrients. 2 de julio de 2024;16(13):2116.
22. Islam MdR, Tamanna T, Mohsin NA, Tanha AF, Sheba NH, Hannan J. Prevalence and barriers to early initiation of breastfeeding among urban poor full-time readymade garments working mothers: a mixed-methods study in Bangladesh. Int Breastfeed J. 18 de junio de 2024;19:42.
23. Hassen HM. Trends and disparities in ever-breastfeeding practice and early breastfeeding initiation in Ethiopia: a 20-year trend analysis from EDHS datasets. BMC Public Health. 19 de septiembre de 2024;24:2558.
24. Martín-Ramos S, Domínguez-Aurrecoechea B, García Vera C, Lorente García Mauriño AM, Sánchez Almeida E, Solís-Sánchez G. [Breastfeeding in Spain and the factors related to its establishment and maintenance: LAyDI Study (PAPenRed)]. Aten Primaria. enero de 2024;56(1):102772.
25. Tran V, Reese Masterson A, Frieson T, Douglass F, Pérez‐Escamilla R, O’Connor Duffany
K. Barriers and facilitators to exclusive breastfeeding among Black mothers: A qualitative study utilizing a modified Barrier Analysis approach. Matern Child Nutr. 13 de septiembre de 2022;19(1):e13428.
26. Gizaw AT, Sopory P, Sudhakar M. Barriers and coping responses towards infant and young child feeding practices in rural Ethiopia: a descriptive qualitative study. BMJ Open. 11 de octubre de 2023;13(10):e077008.
27. Meher C, Zaluchu F. Cultural Influences of Early Food Introduction on Exclusive Breastfeeding Rates in the Nias Islands, Indonesia. J Multidiscip Healthc. 29 de noviembre de 2024;17:5653-63.
28. Abou Jaoude M, Moukarzel S, Kremers SPJ, Gubbels JS. Factors Related to Breastfeeding Support in Lebanese Daycare Centers: A Qualitative Study among Daycare Directors and Employees. Int J Environ Res Public Health. 8 de junio de 2021;18(12):6205.
29. Joseph FI, Earland J. A qualitative exploration of the sociocultural determinants of exclusive breastfeeding practices among rural mothers, North West Nigeria. Int Breastfeed
J. 20 de agosto de 2019;14:38.
30. Rech RS, Chávez BA, Fernandez PB, Fridman CG, Faustino-Silva DD, Hilgert JB, et al. Factors associated with the initiation of breastfeeding in a maternity hospital in Lima, Peru. CoDAS. 28 de junio de 2021;33:e20200173.
31. Gallegos D, Parkinson J, Duane S, Domegan C, Jansen E, Russell-Bennett R. Understanding breastfeeding behaviours: a cross-sectional analysis of associated factors in Ireland, the United Kingdom and Australia. Int Breastfeed J. 2 de diciembre de 2020;15:103.
32. Sharma P, Bansal N, Kaul A. Exclusive breastfeeding practices and factors affecting them in urban areas of Uttar Pradesh. J Fam Med Prim Care. enero de 2025;14(1):38-44.
33. Nuño Martínez N, Wallenborn J, Mäusezahl D, Hartinger SM, Muela Ribera J. Socio- cultural factors for breastfeeding cessation and their relationship with child diarrhoea in the rural high-altitude Peruvian Andes – a qualitative study. Int J Equity Health. 16 de julio de 2021;20:165.
34. Rodríguez-Gallego I, Corrales-Gutierrez I, Gomez-Baya D, Leon-Larios F. Effectiveness of a Postpartum Breastfeeding Support Group Intervention in Promoting Exclusive Breastfeeding and Perceived Self-Efficacy: A Multicentre Randomized Clinical Trial. Nutrients. 28 de marzo de 2024;16(7):988.
35. Diji AKA, Bam V, Asante E, Lomotey AY, Yeboah S, Owusu HA. Challenges and predictors of exclusive breastfeeding among mothers attending the child welfare clinic at a regional hospital in Ghana: a descriptive cross-sectional study. Int Breastfeed J. 9 de marzo de 2017;12:13.
36. Nurokhmah S, Rahmawaty S, Puspitasari DI. Determinants of Optimal Breastfeeding Practices in Indonesia: Findings From the 2017 Indonesia Demographic Health Survey. J Prev Med Pub Health. marzo de 2022;55(2):182-92.
37. Branco J, Manuel AR, Completo S, Marques J, Rodrigues Antão R, Pinto Gago C, et al. Prevalence and Predictive Factors of Exclusive Breastfeeding in the First Six Months of Life. Acta Med Port. 1 de junio de 2023;36(6):416-23.
Published
2025-07-31
How to Cite
1.
Moreira Suárez AS, León Pinos KC, González Piedra AJ, Barzola Velázquez JN, Campos Encalada GE. Sociocultural factors influencing exclusive breastfeeding: a review from public health perspective. PFR [Internet]. 2025Jul.31 [cited 2025Aug.2];10(2). Available from: https://practicafamiliarrural.org/index.php/pfr/article/view/380
Section
Artículos de revisión
Copyright (c) 2025 Rural Family Practice
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
